ACP Guidelines Call for 'Selective Approach' to Low Back Pain Imaging

New guidelines issued this week by the American College of Physicians (ACP) recommend diagnostic imaging for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. For all other patients evidence indicates that routine imaging is not associated with clinically meaningful benefits and can lead to harm through radiation exposure and unnecessary tests and invasive procedures.

According to the recommendations, decisions to perform subsequent imaging should be based on the development of new symptoms or changes in current symptoms, with repeated imaging recommended only in patients with new or changed low back symptoms. Education strategies, including talking points, are outlined in the guidance for clinicians when discussing low back pain imaging with patients.